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Navy and Marine Corps Medical News
September 1, 2000
Navy and Marine Corps Medical News (MEDNEWS) is a weekly
compendium of news and information contributed by commands
throughout the Navy medical department . Information contained
in MEDNEWS stories is not necessarily endorsed by Navy Bureau of
Medicine and Surgery (BUMED) , nor should it be considered
official Navy policy.
BUMED distributes MEDNEWS to Sailors and Marines, their
families, civilian employees and retired Navy and Marine Corps
families. Further distribution is highly encouraged.
Stories in MEDNEWS use these abbreviations after a Navy
medical professional ' s name to show affiliation: MC - Medical
Corps (physician) ; DC - Dental Corps; NC - Nurse Corps; MSC -
Medical Service Corps (clinicians, researchers and
administrative managers) . Hospital Corpsmen (HM) and Dental
Technician (DT) designators are placed in front of their names.
Contents for this week's MEDNEWS:
- Five steps to safer healthcare
- EDIS : A major quality of life program for Navy families
- Physical therapists offer hands on help to the Fleet
- Anthrax question and answer
- TRICARE question and answer
- Healthwatch: Rub-A-Dub: Wash your hands of dirt and grime
Headline: Five Steps to Safer Healthcare
By Army Staff Sgt. Kathleen T. Rhem, American Forces Press
WASHINGTON - It 1 s your health and Defense medical officials
want you to know a few simple steps you can take to safeguard
yourself as a DoD healthcare patient .
"We want to make people understand that there are certain
things they can do that will minimize patient errors and, even
more, will help draw them into their own care, " said Dr. John
Mazzuchi, deputy for clinical and program policy in the Office
of the Assistant Secretary of Defense for Health Affairs. "Each
person is responsible for his or her own health care, too. We
want them to be in a partnership with their doctor. "
To help build this partnership, the Quality Interagency
Committee (QIC) came up with a list of five things people can do
to safeguard themselves from medical errors. The QIC is a group
of healthcare professionals from several federal agencies that
deals with quality and safety issues in medicine.
1 - Speak up if you have questions or concerns. Mazzuchi
said he wants patients to understand that asking questions
shouldn't be seen as challenging physicians . "I'm sure it can
be somewhat uncomfortable for a young enlisted person or a
spouse of a young enlisted person to be sitting in front of a
full colonel who's the physician and start asking questions, " he
Mazzuchi stressed he's not suggesting patients question the
doctor's intelligence, integrity or motivation. But if you have
questions as a patient, you need to get those questions
answered, he said, noting that patients do a better job of
following instructions if they understand the instructions
2 - Keep a list of all medications you take. "Clearly,
medication errors are a major concern because we write so many
prescriptions, " Mazzuchi said. Because medications can
counteract each other or cause a serious reaction when combined,
he said it 's critical for patients to tell their doctor and
pharmacist what medications they're taking, including over-the-
counter drugs and supplements, and any allergies they might
3 - Make sure you get the results of any test or procedure.
"Don't assume that because the doctor has not gotten back to you
in two weeks, everything was fine, " Mazzuchi said. "That doesn't
mean that it couldn't have been lost in the mail or misplaced. "
Individuals should call their healthcare provider and ask
for an explanation of results they don't understand. "If a
result comes back that seems strange, I think it 's important for
a patient to pick up the phone, call the doctor, nurse or lab
tech and say, 'I don't understand these results. Can you go
over them with me?'"
4 - Talk with your doctor or healthcare team about your
options if you need hospital care. "Certain hospitals do a
better job with certain types of surgery than others, " Mazzuchi
said. "So whenever there's an option, you'd want to go to the
hospital that has a record for the best outcomes . "
5 - Make sure you understand what will happen if you need
surgery. "If something different happens from what the
physician tells you to expect, then you need to bring that to
the physician's and nurse's attention immediately. You may be
having complications , and you need to say so right away, "
Mazzuchi said. It 's easier to treat you when a problem is
brought up right away, he noted.
Mazzuchi said DoD is also working to educate healthcare
providers on these issues to make the partnership between
provider and patient easier. "We are educating both those
physicians who are coming up through medical school and those
who are already in practice about the need to go over options
and to bring the patient into the health decisions that are
being made, " he said.
Medical errors might happen, but there are ways to mitigate
their seriousness. "Patient errors don't happen because you
have bad people, they happen because health care providers are
human beings and they make errors, " Mazzuchi said.
"But when you're the most informed, when you really know
what 's going on about your healthcare, when you understand your
options, when you understand what 's probably going to happen to
you and what to expect after you recover, when you understand
what your lab results are and what they mean, you can take
better care of yourself, " he said.
Headline: EDIS : A major quality of life program for Navy
By Lt. Cmdr. Mark C. Russell, MSC, and Cmdr. Robert Buckley, MC,
U. S. Naval Hospital, Yokosuka
YOKOSUKA, Japan - The Navy has one of the finest quality of
life programs to be found within the Department of Defense or
civilian sector — the Educational and Developmental
Intervention Services (EDIS). U.S. Naval Hospital, Yokosuka,
Japan, is responsible for the EDIS program in mainland Japan.
EDIS is a congressionally-mandated, DoD-wide program
dedicated to providing early intervention and medically-related
services to eligible military and civilian members and their
The goals of EDIS are to: improve the functional and
adaptive skills of infants and toddlers with developmental
delays; maximize the learning potential of school age children
with disabilities ; empower families to become active
participants in their child's education and development; and
enhance the independence of children with disabilities to enable
them to function with their peers.
EDIS Japan operates on six DoD installations across 1500
miles and includes Air Force, Army, Navy, and Marine Corps
communities . Family members of Sailors and Marines can receive
comprehensive health related services by well-trained, dedicated
Each clinic has a full complement of EDIS professionals
including occupational therapists, physical therapists, speech
and language pathologists , child psychologists, social workers,
community health nurses, and early childhood special educators.
Audiology, child psychiatry, and developmental pediatrics
services can also be provided.
Active duty service members also benefit from space A
services for audiology, mental health, physical therapy, and
occupational therapy provided by EDIS health care practitioners.
Given the overseas environment and forward-deployed status
of our families, along with the unique stressors associated with
living in Japan, these services constitute a major quality of
life program for active duty families .
In 1993, virtually no space A services were made available
to the overseas community in Japan. This resulted in the early
returns of 78 family members and typically the active duty
member as well . EDIS offers local commands significant cost
savings by preventing the need for early return to families and
personnel transfers .
One of the components of the EDIS program is the ongoing
"child find" activities. The purpose of child find is to
identify children with special needs as early as possible in
order to deliver interventions designed to remediate a child's
disability thus improving their educational and developmental
For many childhood problems , early intervention is critical
for a favorable long-term outcome. In Japan, EDIS providers are
engaged in active community-wide child find activities by
conducting developmental screenings at the Child Development
Centers, health fairs, and primary care clinics. Public
announcements are also made through various written and visual
media including television ads, to inform the community about
EDIS is a cost effective and major quality of life program,
especially for families stationed overseas. Both the quality
and scope of services provided by EDIS is comparable to, if not
exceeding that which our military families receive in the United
Headline: Physical therapists offer hands-on help to the Fleet
By Bill Doughty U.S. Naval Hospital, Yokosuka
YOKOSUKA, Japan - Broken bones, torn muscles and twisted
necks and backs - welcome to the snap-crackle-and-pop world of
physical therapy, where the mission is to get people healthy and
back on their feet as quickly as possible .
U. S. Naval Hospital, Yokosuka, Japan, recently welcomed a
new physical therapist, LTJG Jacqueline Pollock, who is working
side by side with the Fleet to heal people and prevent injuries .
"This is my first duty station, " she said. "Everybody here
is so helpful and willing to give you a helping hand any time
you need it. "
A cadre of Senior Hospital Corpsmen - trained physical
therapy technicians - assist LTJG Pollock. She also works hand-
in-hand with LTJG Doug Hood of Educational and Developmental
Intervention Services and LT Bryan Bost, physical therapist of
USS KITTY HAWK (CV 63) .
Lt . Bost provides musculoskeletal screening and physical
therapy on board thecarrier.
"My job aboard the Kitty Hawk is to reduce the number of
lost work days that our sailors have and to get them back to
work as quickly as possible, " LT Bost said
When the ship is in port, LT Bost provides physical therapy
to patients at the Naval Hospital.
"It gives my patients from the Kitty Hawk a chance to come
over here and do a much more extensive rehab than possible
aboard ship, " he said.
Physical therapists play a critical role in helping commands
maintain their operational readiness . Their patients come from
a very physically active community .
"We have, on board Yokosuka, a young population who like to
get out and play football, softball, soccer, baseball and lift
weights, " said Lt. Bost. "You name it, they like to do it. Not
to mention the new PRT standards which require us to be in a lot
better shape. "
Both physical therapists are actively working with area
fitness coordinators, helping commands get ready for the Navy's
Physical Readiness Test .
"One of my main focuses is patient education, " said LTJG
Pollock. "We're trying to help the fitness coordinators educate
their people on what they can do to prevent injuries before they
start exercising. "
Physical therapists and technicians have a vested interest
in teaching proper exercise technique, preventing injuries, and
reducing the " snap-crackle-and-pop . "
Headline: Anthrax questions and answer
Question: Does anthrax vaccine protect against disease if
someone inhales anthrax spores?
Answer: The original studies of anthrax vaccine showed 93
percent fewer anthrax infections (combining both cutaneous and
inhaled cases of anthrax) among vaccinated people, compared to
In those original studies, no cases of inhaled (inhalation)
anthrax occurred among vaccine recipients, while five cases of
anthrax occurred among unvaccinated or incompletely vaccinated
people. This difference involved too few people to be
statistically conclusive, although the trend is obvious.
It is unethical to intentionally expose human beings to
inhaled anthrax to test the vaccine. Instead, anthrax vaccine
was tested on animals. After 45 animals received one or two
doses of vaccine, 44 of 45 survived aerosol challenge in full
health. That one animal died from anthrax exposure two years
after the second dose of vaccine. This illustrates the
importance of annual booster doses of anthrax vaccine.
These data lead us to expect that anthrax vaccine would be
quite effective in preventing inhaled anthrax.
Headline: TRICARE question and answer
Question: I prefer to see an off base/post civilian doctor.
How do I do that and do I have to pay?
Answer: You can enroll in TRICARE Prime and request a
Primary Care Manager form the civilian TRICARE network.
Otherwise, you can see any physician you want and pay an annual
deductible plus part of the cost . Or, you can choose a civilian
physician from a select network and pay somewhat less. These two
choices are the TRICARE Standard or TRICARE Extra options,
Headline: Healthwatch: Rub-A-Dub: Wash Your Hands of Dirt and
By JOl M. C. Mercado, Naval Hospital Pensacola
For most people hand washing is a subconscious act that
takes place after using the bathroom or before a meal . But
proper hand washing can really be a matter of life or death.
Hungarian doctor Ignaz Semmelweis first recognized the
importance of hand washing as a means of infection control while
working at a hospital in Vienna, Austria during the 1800s.
Semmelweis noticed an alarming number of healthy, new mothers
dying within days after giving birth.
He discovered that student-doctors working in the morgue
were also treating the women. However, the doctors were not
washing their hands. Semmelweis suspected they were spreading
germs from the dead to the new mothers and insisted that they
begin a practice of washing their hands before treating
After educating the doctors of his findings, and
incorporating regular hand washing practices between patients,
Semmelweis saw the mortality rate of the maternity ward drop
Though times have changed and medicine has advanced greatly,
the Association for Professionalism in Infection Control and
Epidemiolgy maintains that hand washing remains the most
powerful defense against infections.
"Germs are all around us and come in different forms, " says
Veronica Hagann, infection control coordinator at Naval Hospital
Germs from other people can linger anywhere; the office
phone, door handles, shopping baskets, money, even the button
you push when you call for an elevator. These are items people
touch and each time they do, they leave their germs and take
"This is how a lot of common illnesses are spread, "
continues Hagann. "Airborne viruses include tuberculosis and
measles, which are released into the air when an infected person
exhales or coughs. Droplet viruses, caused by sneezing and
coughing include meningitis, pneumonia and the flu. Contact
illnesses include staph infections, food poisoning, pink eye,
chicken pox and colds, " said Hagan.
You can unknowingly come in contact with these germs. One
simple rub of the eye or bite of a sandwich using unwashed hands
can introduce any of a number of illnesses into your body. The
odds of you or your family catching any of these are greatly
reduced simply by washing your hands, according to Hagan.
Handwashing removes dirt, organic material and transient
microorganisms . The most important element is friction. You need
to rub your hands together with soap for 10 to 15 seconds to
loosen up the grit and germs and then rinse.
"It is not the soap that kills the germs, " said Hagan. "It
is the act of rubbing the hands that loosens the germs and
rinsing washes the germs away. "
It is important to wash your hands regularly throughout the
day. After cleaning the house, petting a dog or returning from
an outing, it is important to wash away the germs that you have
accumulated on your hands. It especially needs to be done before
cooking or eating.
"In general, normal healthy human skin acts as a barrier to
keep germs out. Dry or cracked hands have less resistance to
germs. If you have cracks or cuts in your skin, germs have
access into your body, " said Hagan.
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